Neurological symptoms due to Coronavirus disease 2019

  • Farage Ftiha | CUNY Brooklyn College, NY, United States.
  • Moshe Shalom Sackler School of Medicine, NY, United States.
  • Henry Jradeh CUNY Brooklyn College, NY, United States.


In this review, we focus on summarizing everything that is known about the neurological effects of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-COV-2). It has been shown that Coronavirus Disease 2019 (Covid-19) may result in neuromuscular disorders or damage to nerves outside of the brain and spinal cord, which may lead to weakness, numbness, and pain. Published literature has stated that SARS-COV-1 may infect the central nervous system and due to its similarities to SARS-COV-2, we suspect that SARS-COV-2 has the same potential. We conclude that Covid-19 has neurological manifestations. Further research should be done in this field to understand the full extent of this virus.



PlumX Metrics


Download data is not yet available.


Baig, A. M., Khaleeq, A., Ali, U., & Syeda, H. (2020). Evidence of the COVID-19 Virus Targeting the CNS: Tissue Distribution, Host-Virus Interaction, and Proposed Neurotropic Mechanisms. In ACS Chemical Neuroscience. American Chemical Society.
Basso, L. G. M., Vicente, E. F., Crusca, E., Cilli, E. M., & Costa-Filho, A. J. (2016). SARS-CoV fusion peptides induce membrane surface ordering and curvature. Scientific Reports, 6.
Besecker, B. Y., Exline, M. C., Hollyfield, J., Phillips, G., DiSilvestro, R. A., Wewers, M. D., & Knoell, D. L. (2011). A comparison of zinc metabolism, inflammation, and disease severity in critically ill infected and noninfected adults early after intensive care unit admission. American Journal of Clinical Nutrition, 93(6), 1356–1364.
Chang, D., Lin, M., Wei, L., Xie, L., Zhu, G., Dela Cruz, C. S., & Sharma, L. (2020). Epidemiologic and Clinical Characteristics of Novel Coronavirus Infections Involving 13 Patients Outside Wuhan, China. In JAMA - Journal of the American Medical Association (Vol. 323, Issue 11, pp. 1092–1093). American Medical Association.
Chen, Y., Tao, J., Sun, Y., Wu, A., Su, C., Gao, G., Cai, H., Qiu, S., Wu, Y., Ahola, T., & Guo, D. (2013). Structure-Function Analysis of Severe Acute Respiratory Syndrome Coronavirus RNA Cap Guanine-N7-Methyltransferase. Journal of Virology, 87(11), 6296–6305.
Coen, M., Jeanson, G., Alejandro Culebras Almeida, L., Hübers, A., Stierlin, F., Najjar, I., Ongaro, M., Moulin, K., Makrygianni, M., Leemann, B., Kronig, I., Bertrand, J., Reny, J.-L., Schibler, M., & Serratrice, J. (2020). Guillain-Barré Syndrome as a Complication of SARS-CoV-2 Infection. Brain, Behavior, and Immunity.
Dyall, J., Gross, R., Kindrachuk, J., Johnson, R. F., Olinger, G. G., Hensley, L. E., Frieman, M. B., & Jahrling, P. B. (2017). Middle East Respiratory Syndrome and Severe Acute Respiratory Syndrome: Current Therapeutic Options and Potential Targets for Novel Therapies. In Drugs (Vol. 77, Issue 18, pp. 1935–1966). Springer International Publishing.
Engel, W. K. (2003). Intravenous immunoglobulin G is remarkably beneficial in chronic immune dysschwannian/dysneuronal polyneuropathy, diabetes-2 neuropathy, and potentially in severe acute respiratory syndrome. In Acta Myologica (Vol. 22, Issue DEC., pp. 97–103).
Fehr, A. R., & Perlman, S. (2015). Coronaviruses: An overview of their replication and pathogenesis. In Coronaviruses: Methods and Protocols (pp. 1–23). Springer New York.
Graham Carlos, W., Dela Cruz, C. S., Cao, B., Pasnick, S., & Jamil, S. (2020). Novel Wuhan (2019-NCoV) coronavirus. In American Journal of Respiratory and Critical Care Medicine (Vol. 201, Issue 4, pp. P7–P8). American Thoracic Society.
Hoffmann, M., Kleine-Weber, H., Schroeder, S., Krüger, N., Herrler, T., Erichsen, S., Schiergens, T. S., Herrler, G., Wu, N.-H., Nitsche, A., Müller, M. A., Drosten, C., & Pöhlmann, S. (2020). SARS-CoV-2 Cell Entry Depends on ACE2 and TMPRSS2 and Is Blocked by a Clinically Proven Protease Inhibitor. Cell, 181(2), 271-280.e8.
Huang, C., Wang, Y., Li, X., Ren, L., Zhao, J., Hu, Y., Zhang, L., Fan, G., Xu, J., Gu, X., Cheng, Z., Yu, T., Xia, J., Wei, Y., Wu, W., Xie, X., Yin, W., Li, H., Liu, M., … Cao, B. (2020). Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. The Lancet, 395(10223), 497–506.
Hung, E. C. W., Chim, S. S. C., Chan, P. K. S., Tong, Y. K., Ng, E. K. O., Chiu, R. W. K., Leung, C. B., Sung, J. J. Y., Tam, J. S., & Lo, Y. M. D. (2003b). Detection of SARS Coronavirus RNA in the Cerebrospinal Fluid of a Patient with Severe Acute Respiratory Syndrome. In Clinical Chemistry (Vol. 49, Issue 12, pp. 2108–2109). Oxford University Press.
Hwang, C. S. (2006). Olfactory neuropathy in severe acute respiratory syndrome: Report of a case. Acta Neurologica Taiwanica, 15(1), 26–28.
Lai, C. C., Shih, T. P., Ko, W. C., Tang, H. J., & Hsueh, P. R. (2020). Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and coronavirus disease-2019 (COVID-19): The epidemic and the challenges. In International Journal of Antimicrobial Agents (Vol. 55, Issue 3). Elsevier B.V.
Lau, S. K. P., Woo, P. C. Y., Li, K. S. M., Huang, Y., Tsoi, H. W., Wong, B. H. L., Wong, S. S. Y., Leung, S. Y., Chan, K. H., & Yuen, K. Y. (2005). Severe acute respiratory syndrome coronavirus-like virus in Chinese horseshoe bats. Proceedings of the National Academy of Sciences of the United States of America, 102(39), 14040–14045.
Li, K., Wohlford-Lenane, C., Perlman, S., Zhao, J., Jewell, A. K., Reznikov, L. R., Gibson-Corley, K. N., Meyerholz, D. K., & McCray, P. B. (2015). Middle east respiratory syndrome coronavirus causes multiple organ damage and lethal disease in mice transgenic for human dipeptidyl peptidase 4. Journal of Infectious Diseases, 212(11), 712–722.
Lipsitch, M., Finelli, L., Heffernan, R. T., Leung, G. M., & Redd, S. C. (2011). Improving the evidence base for decision making during a pandemic: The example of 2009 influenza A/H1N1. In Biosecurity and Bioterrorism (Vol. 9, Issue 2, pp. 89–115).
Liu, K., Pan, M., Xiao, Z., & Xu, X. (2020). Neurological manifestations of the coronavirus (SARS-CoV-2) pandemic 2019-2020. In Journal of Neurology, Neurosurgery and Psychiatry. BMJ Publishing Group.
Mao, L., Jin, H., Wang, M., Hu, Y., Chen, S., He, Q., Chang, J., Hong, C., Zhou, Y., Wang, D., Miao, X., Li, Y., & Hu, B. (2020). Neurologic Manifestations of Hospitalized Patients with Coronavirus Disease 2019 in Wuhan, China. JAMA Neurology.
Otmani, H. El, Moutawakil, B. El, Rafai, M.-A., Benna, N. El, Kettani, C. El, Soussi, M., Mdaghri, N. El, Barrou, H., & Afif, H. (2020). Covid-19 and Guillain-Barré syndrome: More than a coincidence! Revue Neurologique.
Pisano, M., & Hilas, O. (2016). Zinc and Taste Disturbances in Older Adults: A Review of the Literature. The Consultant Pharmacist : The Journal of the American Society of Consultant Pharmacists, 31(5), 267–270.
Pleasure, S. J., Green, A. J., & Josephson, S. A. (2020). The Spectrum of Neurologic Disease in the Severe Acute Respiratory Syndrome Coronavirus 2 Pandemic Infection: Neurologists Move to the Frontlines. In JAMA Neurology. American Medical Association.
Poyiadji, N., Shahin, G., Noujaim, D., Stone, M., Patel, S., & Griffith, B. (2020). COVID-19–associated Acute Hemorrhagic Necrotizing Encephalopathy: CT and MRI Features. Radiology, 201187.
Sellner, J., Taba, P., Öztürk, S., & Helbok, R. (2020). The need for neurologists in the care of COVID‐19 patients. European Journal of Neurology, ene.14257.
Spinato, G., Fabbris, C., Polesel, J., Cazzador, D., Borsetto, D., Hopkins, C., & Boscolo-Rizzo, P. (2020). Alterations in Smell or Taste in Mildly Symptomatic Outpatients with SARS-CoV-2 Infection. In JAMA - Journal of the American Medical Association. American Medical Association.
te Velthuis, A. J. W., van den Worm, S. H. E., Sims, A. C., Baric, R. S., Snijder, E. J., & van Hemert, M. J. (2010). Zn2+ Inhibits Coronavirus and Arterivirus RNA Polymerase Activity In Vitro and Zinc Ionophores Block the Replication of These Viruses in Cell Culture. PLoS Pathogens, 6(11), e1001176.
The RNA polymerase activity of SARS-coronavirus nsp12 is primer dependent. (n.d.). Retrieved May 5, 2020, from
Tsai, L. K., Hsieh, S. T., & Chang, Y. C. (2005). Neurological manifestations in severe acute respiratory syndrome. In Acta Neurologica Taiwanica (Vol. 14, Issue 3, pp. 113–119).
Tsai, L. K., Hsieh, S. T., Chao, C. C., Chen, Y. C., Lin, Y. H., Chang, S. C., & Chang, Y. C. (2004). Neuromuscular disorders in severe acute respiratory syndrome. Archives of Neurology, 61(11), 1669–1673.
Walls, A. C., Tortorici, M. A., Frenz, B., Snijder, J., Li, W., Rey, F. A., DiMaio, F., Bosch, B. J., & Veesler, D. (2016). Glycan shield and epitope masking of a coronavirus spike protein observed by cryo-electron microscopy. Nature Structural and Molecular Biology, 23(10), 899–905.
Wang, D., Hu, B., Hu, C., Zhu, F., Liu, X., Zhang, J., Wang, B., Xiang, H., Cheng, Z., Xiong, Y., Zhao, Y., Li, Y., Wang, X., & Peng, Z. (2020). Clinical Characteristics of 138 Hospitalized Patients with 2019 Novel Coronavirus-Infected Pneumonia in Wuhan, China. JAMA - Journal of the American Medical Association, 323(11), 1061–1069.
Wessels, I., Maywald, M., & Rink, L. (2017). Zinc as a gatekeeper of immune function. In Nutrients (Vol. 9, Issue 12). MDPI AG.
WHO Director-General’s opening remarks at the media briefing on COVID-19 - 11 March 2020. (n.d.). Retrieved May 5, 2020, from
Wong, C. P., Rinaldi, N. A., & Ho, E. (2015). Zinc deficiency enhanced inflammatory response by increasing immune cell activation and inducing IL6 promoter demethylation. Molecular Nutrition & Food Research, 59(5), 991–999.
Xu, X. W., Wu, X. X., Jiang, X. G., Xu, K. J., Ying, L. J., Ma, C. L., Li, S. B., Wang, H. Y., Zhang, S., Gao, H. N., Sheng, J. F., Cai, H. L., Qiu, Y. Q., & Li, L. J. (2020). Clinical findings in a group of patients infected with the 2019 novel coronavirus (SARS-Cov-2) outside of Wuhan, China: Retrospective case series. The BMJ, 368.
Zhang, C., Wu, Z., Li, J. W., Zhao, H., & Wang, G. Q. (2020). The cytokine release syndrome (CRS) of severe COVID-19 and Interleukin-6 receptor (IL-6R) antagonist Tocilizumab may be the key to reduce the mortality. International Journal of Antimicrobial Agents.
SARS-COV-2, Covid-19, Neurological effects
  • Abstract views: 665

  • PDF: 299
  • HTML: 0
How to Cite
Ftiha, F., Shalom, M., & Jradeh, H. (2020). Neurological symptoms due to Coronavirus disease 2019. Neurology International, 12(1).